Abstract
Purpose of the study
The aim of the study was to review the surgical management of Neuromuscular Scoliosis (NMS) and its outcome.
Method
NMS patients who underwent surgery between 2001 and 2012 were identified. Case notes, surgical data, complications and radiographic results were reviewed retrospectively. The families were contacted telephonically. Sitting posture status and whether the parents and patients would opt to have the surgery again if given the opportunity, was assessed.
Summary of Results
96 NMS patients had corrective spinal surgery performed by a single surgeon in 4 institutions. Cerebral Palsy was the most common underlying cause (18) followed by Myelomeningocoele (15), SMA (12) and post spinal cord injury scoliosis (10).
52 patients were female and 44 male with a median age of 13.6 years at surgery. The delay to surgery after presentation was 20.6 months. Seventy patients received posterior only based surgery and 12 patients had anterior only fusions. Another 12 patients had a 2-stage procedure with a delay of 12 days between operations.
The average blood loss was 1600ml and duration of surgery 222 minutes. Forty seven patients had pedicle screw only constructs and 46 patients' constructs included the pelvis. An average of 14.2 levels were included in the construct. The primary curve was corrected from 84.4° to 32.7° which was mostly maintained throughout the follow-up period. 55 patients had a follow-up of greater or equal to 2 years.
Only one patient reported not having improved his sitting posture. 3 parents and 5 patients would opt not to have the surgery again.
Conclusion
Spine fusion in NMS is effective in correcting and maintaining correction of associated scoliosis despite the risk of major complications. Most patients and family value the clinical improvement and would agree to surgery again.
NO DISCLOSURES
